Objective: The purpose of this study is to evaluate the remineralization potential of the self-assembling peptideP11-4 (Curodont repair) versus highly concentrated fluoride agent (Enamelast) after single & double applications (Atomic Force Microscopy study) and to evaluate the clinical efficacy of both agents in patients with early carious lesions. Materials and methods: Twenty children ranging from 10-16 years of age were selected with at least 2 white lesions (WSL) detected clinically on the buccal surface of permanent anterior teeth, one on each side. Patients were randomly assigned
into 2 groups according to the re-mineralizing agent applied. A1: 20 WSL re-mineralized with Curodont. A2: 20 WSL re-mineralized with Fluoride varnish. Each group was further subdivided into 2 subgroups according to the number of applications with (A1B1):10 WSL treated with Curodont single application, (A1B2): 10 WSL treated with Curodont double applications, (A2B1): 10 WSL treated with fluoride single application and (A2B2): 10 WSL treated with fluoride double applications. Also this study was carried on 40 freshly extracted young upper or lower premolars. Teeth were extracted from patients ranging from 14 to 20 years, for orthodontic purpose. Forty enamel samples were prepared from teeth and then examined before and after demineralization and after remineralization with Atomic Force Microscopy (AFM). Results: Both remineralizing agents showed decrease in enamel average roughness after remineralization, however
group (A1: Curodont) showed the lowest results. Both groups show gradual decrease in the International Caries Detection Assessment System scores (ICDAS) from the base line to reach the lowest level after 6 months. The best results of ICDAS scores were recorded in subgroup (A1B2: Curodont double application). Both subgroups of curodont repair revealed an extremely significant higher percent increase of radiodensity percentage in comparison to fluoride subgroups. No significant difference between the 2 remineralizaing agents on the pH of saliva. Conclusion: Self-assembling peptides
(Curodont repair) was successful as a remineralizing agent in young permanent teeth with white spot lesions.